GI block i-Human cases Questions With
Correct Answers
Clues about the patient's stool for Ms. Schilling
If floating high fat content, if watery the colon is not able to absorb water, urgency also
indicates more water in stool
Role of the gallbladder for Ms. Schilling
Patient had gallstones, gallbladder is responsible for making bile so could be recurrence
of gallstones. Gallstones can be stuck in gallbladder and often in the sphincter of Oddi
area. This could be the reason for her pain.
Differential diagnoses for Ms. Schilling
Gluten sensitivity, gallstones, irritable bowel syndrome, pancreatitis maybe (but usually
related to alcohol use), substance abuse--possibly laxative abuse in this case,
ulcerative colitis, anxiety/stress, cancer, giardiasis (from contaminated water)
Significant findings for Ms. Schilling
Low albumin (protein) levels (malabsorption), gall stones were present but no signs of
inflammation, macrocytic anemia due to low vitamin B12 (malabsorption), positive for
glandin IgA and glandin IgG antibodies (Celiac), positive endomysial Ab screen (Celiac)
Findings which support Ms. Schilling's diagnosis
Diarrhea (with fecal fat) associated with abdominal pain worsened with wheat products,
weight loss due to malabsorption, positive antibodies for gliadin and endomysium, to
confirm diagnosis obtain biopsy of small intestine via endoscopy (will show flat mucosal
villi surface with plasmacytic infiltration of subepithelial region), coagulopathy
(deficiencies)
5 complications specific to Celiac disease for Ms. Schilling
Correct Answers
Clues about the patient's stool for Ms. Schilling
If floating high fat content, if watery the colon is not able to absorb water, urgency also
indicates more water in stool
Role of the gallbladder for Ms. Schilling
Patient had gallstones, gallbladder is responsible for making bile so could be recurrence
of gallstones. Gallstones can be stuck in gallbladder and often in the sphincter of Oddi
area. This could be the reason for her pain.
Differential diagnoses for Ms. Schilling
Gluten sensitivity, gallstones, irritable bowel syndrome, pancreatitis maybe (but usually
related to alcohol use), substance abuse--possibly laxative abuse in this case,
ulcerative colitis, anxiety/stress, cancer, giardiasis (from contaminated water)
Significant findings for Ms. Schilling
Low albumin (protein) levels (malabsorption), gall stones were present but no signs of
inflammation, macrocytic anemia due to low vitamin B12 (malabsorption), positive for
glandin IgA and glandin IgG antibodies (Celiac), positive endomysial Ab screen (Celiac)
Findings which support Ms. Schilling's diagnosis
Diarrhea (with fecal fat) associated with abdominal pain worsened with wheat products,
weight loss due to malabsorption, positive antibodies for gliadin and endomysium, to
confirm diagnosis obtain biopsy of small intestine via endoscopy (will show flat mucosal
villi surface with plasmacytic infiltration of subepithelial region), coagulopathy
(deficiencies)
5 complications specific to Celiac disease for Ms. Schilling
